胸腔镜下肺大疱切除术中不同胸膜固定术用于原发性自发性气胸患者的临床价值  

Clinical value of different pleurodesis in patients with primary spontaneous pneumothorax during thoracoscopic bullotomy

作　　者：刘金鑫 郑英 LIU Jin-xin;ZHENG Ying(Department of Thoracic Surgery,Yibin No.2 People's Hospital,Yibin 644000,Sichuan,China;Department of Anesthesiology,Yibin No.2 People's Hospital,Yibin 644000,Sichuan,China)

机构地区：[1]宜宾市第二人民医院胸外科,四川宜宾644000 [2]宜宾市第二人民医院麻醉科,四川宜宾644000

出　　处：《川北医学院学报》2023年第8期1118-1121,共4页Journal of North Sichuan Medical College

摘　　要：目的:探讨胸腔镜下肺大疱切除术中不同胸膜固定术用于原发性自发性气胸患者的临床价值。方法:选取84例原发性自发性气胸患者作为研究对象,按照术中胸膜固定方式不同将患者分为观察组(n=45)与对照组(n=39)。两组患者均行胸腔镜下肺大疱切除术,观察组患者选用红霉素涂擦进行胸膜固定,对照组患者选用机械性胸膜摩擦进行胸膜固定。比较两组患者临床疗效、围术期指标、疼痛情况、氧化应激相关指标、肺功能相关指标及术后并发症发生情况。结果:观察组的临床总有效率为93.33%,高于对照组的74.36%(P<0.05)。观察组手术时间、术中出血量、置管时间、住院时间均低于对照组(P<0.05)。观察组疼痛分级为1级比例为46.67%,高于对照组的22.22%(P<0.05)。观察组超氧化物歧化酶(SOD)水平高于对照组(P<0.05);丙二醛(MDA)水平低于对照组(P<0.05)。观察组FEV1、FVC、PEF、FEV1/FVC水平均高于对照组(P<0.05)。观察组并发症总发生率低于对照组(P<0.05)。结论:与机械性胸膜摩擦相比,应用红霉素涂擦的方式来进行胸膜固定可提高原发性自发性气胸患者的临床疗效,促进术后恢复,改善疼痛及氧化应激,提高肺功能,降低术后并发症,值得临床推广。Objective:To investigate the clinical value of different pleuroexy in patients with primary spontaneous pneumothorax during thoracoscopic bullotomy.Methods:84 patients with primary spontaneous pneumothorax were divided into the observation group(n=45)and the control group(n=39)according to different methods of pleural fixation.Both groups underwent thoracoscopic bullotomy.Erythromycin was applied for pleural fixation in the observation group and mechanical pleural friction was applied for pleural fixation in the control group.The clinical efficacy,perioperative indexes,pain,oxidative stress,lung function indexes and postoperative complications were compared between the two groups.Results:The total effective rate of the observation group was 93.33%,which was higher than that of the control group 74.36%(P<0.05).The operation time,intraoperative blood loss,catheterization time and hospital stay in the observation group were lower than those in the control group(P<0.05).The proportion of patients with grade 1 pain in the observation group was 46.67%,which was higher than that in the control group 22.22%(P<0.05).The level of superoxide dismutase(SOD)in observation group was higher than that in control group(P<0.05).The level of malondialdehyde(MDA)was lower than that of control group(P<0.05).FEV1,FVC,PEF and FEV1/FVC in the observation group were higher than those in the control group(P<0.05).The total complication rate of observation group was lower than that of control group(P<0.05).Conclusion:Compared with mechanical pleural friction,erythromycin application of pleural fixation can improve the clinical efficacy of patients with primary spontaneous pneumothorax,promote postoperative recovery,improve pain,oxidative stress response,and lung function,and reduce postoperative complications,which is worthy of clinical promotion.

关 键 词：气胸 胸腔镜 肺大疱切除术 疼痛 

分 类 号：R655.3[医药卫生—外科学]